McNair Angus G K, MacKichan F, Donovan J L, Brookes S T, Avery K N L, Griffin S M, Crosby T, Blazeby J M
School of Social & Community Medicine, University of Bristol, 39 Whatley Road, Bristol, BS8 2PS, UK.
Severn School of Surgery, Deanery House, Unit D, Vantage Office Park, Old Gloucester Road, Hambrook, Bristol, BS16 1GW, UK.
BMC Cancer. 2016 Mar 31;16:258. doi: 10.1186/s12885-016-2292-3.
The information surgeons impart to patients and information patients want about surgery for cancer is important but rarely examined. This study explored information provided by surgeons and patient preferences for information in consultations in which surgery for oesophageal cancer surgery was discussed.
Pre-operation consultations in which oesophagectomy was discussed were studied in three United Kingdom hospitals and patients were subsequently interviewed. Consultations and interviews were audio-recorded, transcribed in full and anonymized. Interviews elicited views about the information provided by surgeons and patients' preferences for information. Thematic analysis of consultation-interview pairs was used to investigate similarities and differences in the information provided by surgeons and desired by patients.
Fifty two audio-recordings from 31 patients and 7 surgeons were obtained (25 consultations and 27 patient interviews). Six consultations were not recorded because of equipment failure and four patients declined an interview. Surgeons all provided consistent, extensive information on technical operative details and in-hospital surgical risks. Consultations rarely included discussion of the longer-term outcomes of surgery. Whilst patients accepted that information about surgery and risks was necessary, they really wanted details about long-term issues including recovery, impact on quality of life and survival.
This study demonstrated a need for surgeons to provide information of importance to patients concerning the longer term outcomes of surgery. It is proposed that "core information sets" are developed, based on surgeons' and patients' views, to use as a minimum in consultations to initiate discussion and meet information needs prior to cancer surgery.
外科医生向患者传达的信息以及患者想要了解的癌症手术信息非常重要，但很少受到审视。本研究探讨了外科医生提供的信息以及在讨论食管癌手术的会诊中患者对信息的偏好。
在英国的三家医院研究了讨论食管切除术的术前会诊情况，随后对患者进行了访谈。会诊和访谈进行了录音，全部转录并匿名处理。访谈引出了关于外科医生提供的信息以及患者对信息偏好的观点。通过对会诊 - 访谈配对进行主题分析，来调查外科医生提供的信息与患者期望的信息之间的异同。
获得了来自31名患者和7名外科医生的52份录音（25次会诊和27次患者访谈）。由于设备故障，6次会诊未记录，4名患者拒绝接受访谈。所有外科医生都提供了关于手术技术细节和院内手术风险的一致且详尽的信息。会诊很少包括对手术长期结果的讨论。虽然患者承认关于手术和风险的信息是必要的，但他们真正想要的是关于长期问题的细节，包括恢复情况、对生活质量的影响和生存率。
本研究表明外科医生需要提供对患者而言重要的关于手术长期结果的信息。建议根据外科医生和患者的观点制定“核心信息集”，在癌症手术前的会诊中至少作为启动讨论和满足信息需求的依据使用。
